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Stay safe on the slopes

skier

Mr Martin Klinke, orthopaedic surgeon, The London Foot and Ankle Centre, Bupa Cromwell Hospital

 

Improvements to ski boots make it considerably safer to ski than ever before. However, fractures to feet and ankles continue to occur when skiiers find themselves in specific situations. Mr Martin Klinke discusses these types of ski injuries and the treatments needed for a succesful recovery.


Ankle and foot winter sports injuries

Statistically, in terms of foot and ankle injury risk, it is now considerably safer to ski compared with stepping onto a football pitch. Overall, ski injury rates have come down during the past decade with, on average, just over two injuries per 1,000 ski days*. A major factor, particularly for the safety of the foot and ankle, is improvement to the ski boot, which now provides far better protection than ever before.


Snow-boarder’s foot injuries

However, at the London Foot and Ankle Centre, we still see several injuries which affect winter sports enthusiasts. The so called “snow-boarder’s fracture” is a rotational injury that usually impacts the front snowboard foot. The fracture is not always visible on a normal X-ray and people sometimes even return home and to work, functioning fairly well, but experiencing pain. The affected area is a part of the talus bone, located above the heel, deep within the ankle and is known medically as the lateral process of talus.

 

If this injury is diagnosed early enough, treatment is simple and very effective, with the insertion of a small (surgical) screw to stabilise the joint. Left untreated, the injury can eventually lead to arthritic changes within the back of the foot.

 

Ankle injuries from ski jumping

Another injury we see occurs when a skier jumps and lands on an uneven surface, resulting in a dramatic reduction in speed, a forward jolt and sudden contraction of muscles. This causes an injury to the muscle that runs down the outside of the lower leg and helps to rotate the ankle outwards. This is known medically as a dislocation of the peroneus longus. Most often, this injury cannot be detected on an X-ray, but by using an ultrasound or MRI scan, a specialist can detect this injury easily. This injury can also become a chronic source of pain and weakness in the ankle joint area.

 

Other winter sports ankle fractures

We do still see ankle fractures and it is quite often after the skis come off that these sorts of injuries take place. After a long morning on the slopes, when you walk to a café in your ski boots, the surface is often slippery and your feet take some time to adjust to a different movement process and surface. This is when slips and falls resulting in fractures often happen.


The importance of well-fitting ski boots in preventing injury

It’s important your ski boots fit correctly and tightly to avoid injury. I recently saw a patient who had a swollen ankle from a previous injury; he told me he had to keep his ski boots loose because it was too painful to wear them tightly. Fortunately, this did not result in further injury, but it could well have done. Loose ski boots will not offer the protection you need and potentially create a safety hazard.

Bupa Cromwell Hospital private GP service

 If you have underlying weakness or pain in any part of your feet, you can buy specially moulded boots which accommodate the need for greater width or sensitive parts of the foot. You can also buy boots that allow air to be pumped into the boot, increasing comfort.

 

Essentially, if your boots are not comfortable when you tighten them, they are not the right boots for you; find alternatives which are a better, safer fit.

 

*statistics from www.ski-injury.com

Martin Klinke, orthopaedic surgeon, The London Foot and Ankle Centre, Bupa Cromwell Hospital

Profile of the author

Martin Klinke graduated from medical school in Frankfurt and received his master's degree in Sports Medicine from the University of Nice. He completed his post graduate orthopaedic training in major teaching hospitals Germany and Paris, followed by a specialised foot and ankle fellowship at the Royal National Orthopaedic Hospital in Stanmore. In 2001 Mr Klinke worked for a year with Professor Hinterman, a world leading specialist in ankle replacements. Mr Klinke was appointed Consultant Orthopaedic Surgeon at Guy's and St Thomas' hospitals in 2002, and joined the London Foot and Ankle Clinc at Bupa Cromwell Hospital in 2003 where he has been based full-time since 2007. 

Information about musculoskeletal problems